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Source: Europace
Condition: Bleeding

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Total 49 results found since Jan 2013.

Atrial high-rate episodes: prevalence, stroke risk, implications for management, and clinical gaps in evidence
AbstractSelf-terminating atrial arrhythmias are commonly detected on continuous rhythm monitoring, e.g. by pacemakers or defibrillators. It is unclear whether the presence of these arrhythmias has therapeutic consequences. We sought to summarize evidence on the prevalence of atrial high-rate episodes (AHREs) and their impact on risk of stroke. We performed a comprehensive, tabulated review of published literature on the prevalence of AHRE. In patients with AHRE, but without atrial fibrillation (AF), we reviewed the stroke risk and the potential risk/benefit of oral anticoagulation. Atrial high-rate episodes are found in 10...
Source: Europace - August 3, 2019 Category: Cardiology Source Type: research

Alcohol-related hospitalization is associated with increased risk of ischaemic stroke among low-risk patients with atrial fibrillation
ConclusionThe presence of a previous hospitalization with an alcohol-related disease was associated with a small but significant increase in the risk of stroke among low-risk AF patients. More research about relation between alcohol use and ischaemic stroke in AF patients is warranted.
Source: Europace - February 23, 2017 Category: Cardiology Source Type: research

The budget impact of left atrial appendage closure compared with adjusted-dose warfarin and dabigatran etexilate for stroke prevention in atrial fibrillation
Conclusion The majority of LAAC costs are borne in the first year, while costs for pharmaceutical strategies continue to accrue year on year. Thus, LAAC represents an opportunity for savings to healthcare systems in the long term. This is an important consideration for payers in evaluating lifetime treatment strategies in AF.
Source: Europace - July 29, 2014 Category: Cardiology Authors: Amorosi, S. L., Armstrong, S., Da Deppo, L., Garfield, S., Stein, K. Tags: Atrial fibrillation Source Type: research

Stroke and bleeding with non-vitamin K antagonist oral anticoagulant or warfarin treatment in patients with non-valvular atrial fibrillation: a population-based cohort study
ConclusionThis population-based cohort study of routine care indicates similar or better effectiveness and safety with NOAC compared with warfarin treatment. NOACs were associated with fewer intracranial bleeds, but more gastrointestinal bleeds.
Source: Europace - February 10, 2017 Category: Cardiology Source Type: research

Ischaemic stroke prevention in patients with atrial fibrillation and high bleeding risk: opportunities and challenges for percutaneous left atrial appendage occlusion
This article is a summary of the Third Global Summit on LAA occlusion, 15 March 2013, Barcelona, Spain.
Source: Europace - May 5, 2014 Category: Cardiology Authors: Lewalter, T., Kanagaratnam, P., Schmidt, B., Rosenqvist, M., Nielsen-Kudsk, J. E., Ibrahim, R., Albers, B. A., Camm, A. J. Tags: REVIEW Source Type: research

Challenges in comparing the non-vitamin K antagonist oral anticoagulants for atrial fibrillation-related stroke prevention
AbstractThe aim of this review is to provide context for meta-analyses interpreting data from phase III stroke prevention studies of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with non-valvular atrial fibrillation (NVAF). Differences between the four phase III NOAC stroke prevention studies in patients with NVAF (ROCKET AF, ARISTOTLE, RE-LY, and ENGAGE AF), their potential impact on outcomes, and inter-study differences were evaluated, as well as the potential role of real-world evidence in evaluating NOACs in this setting. Study design differences included blinding strategy, dose-reduction options, a...
Source: Europace - October 13, 2017 Category: Cardiology Source Type: research

Stroke and bleeding risk evaluation in atrial fibrillation: results of the European Heart Rhythm Association survey
The aim of this European Heart Rhythm Association (EHRA) survey was to assess clinical practice in relation to stroke and bleeding risk evaluation in atrial fibrillation, particularly regarding the use of risk evaluation schemes, among members of the EHRA electrophysiology (EP) research network. In this EP Wire survey, we have provided some insights into current practice in Europe for the use of these risk assessment schemes. There were some obvious practice differences. However, reassuring information on current practice in Europe was evident, but more focus on renal function is warranted, especially facing the fact that ...
Source: Europace - May 5, 2014 Category: Cardiology Authors: Larsen, T. B., Potpara, T., Dagres, N., Pison, L., Estner, H., Blomstrom-Lundqvist, C., Scientific Initiative Committee, European Heart Rhythm Association, Blomstrom-Lundqvist, Bongiorni, Chen, Dagres, Estner, Hernandez-Madrid, Hocini, Larsen, Pison, Potp Tags: EP WIRE Source Type: research

The unfinished issue of ischaemic stroke and embolic events during ablation for atrial fibrillation: the authors' reply
We thank Dr. Providenciaet al.1 for the concern and comments on our article.2 We agree with them that discontinuation of warfarin before catheter ablation for atrial fibrillation (AF) is likely associated with increased risk of periprocedural thrombo-embolic events. We cannot comment on the effects of different periprocedural anticoagulation strategy used in our cohort on thrombo-embolic events during AF ablation because of only a small minority of patients who were anti-coagulated with uninterrupted warfarin. Although several reports indicate that AF ablation can be performed safely with fewer stroke and bleeding complica...
Source: Europace - March 17, 2017 Category: Cardiology Source Type: research

115 Anticoagulation in atrial fibrillation – a single-centre audit on patient education, stroke and bleeding risk assessments and use of direct oral anticoagulants (DOACs)
Objective: To assess adherence to the National Institute of Health and Care Excellence (NICE) guidelines on management of atrial fibrillation in adults, specifically the provision of a personalised package of care and information to patients, and stroke and bleeding risk assessments. To assess the frequency of use of DOACs as the anticoagulant of choice.
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

Atrial fibrillation patients do not benefit from acetylsalicylic acid
Conclusion Acetylsalicylic acid as monotherapy in stroke prevention of atrial fibrillation has no discernable protective effect against stroke, and may even increase the risk of ischaemic stroke in elderly patients. Thus, our data support the new European guidelines recommendation that ASA as monotherapy should not be used as stroke prevention in atrial fibrillation.
Source: Europace - May 5, 2014 Category: Cardiology Authors: Sjalander, S., Sjalander, A., Svensson, P. J., Friberg, L. Tags: Atrial fibrillation Source Type: research

Left atrial or left atrial appendage thrombus as a cardiac source of embolus: that is the question or Faust bargain for left atrial appendage closure? —Authors’ reply
We thank Yakutet al. for their comments on our Point of view ‘Where are clots in atrial fibrillation? Did we have the wrong assumptions over the last decades?’. In the manuscript, we addressed how in the old literature the frequency of left atrial cavity thrombi is probably largely overestimated.1 In fact, based on an accurate review, and on our experience, the real frequency of atrial thrombi located outside the left appendage (LAA) is extremely low, and it might be an important rationale for LAA occlusion interventions. The aim of this last sentence was to give evidence to procedures focusing on LAA, not promoting LA...
Source: Europace - November 30, 2020 Category: Cardiology Source Type: research

Non-vitamin K antagonist oral anticoagulation agents in anticoagulant naive atrial fibrillation patients: Danish nationwide descriptive data 2011-2013
Conclusion Among oral anticoagulation-naïve AF patients initiated on oral anticoagulation in Denmark, warfarin initiation has declined since the introduction of dabigatran in August 2011. Dabigatran is the most frequently used alternative option to warfarin; however, use of rivaroxaban and apixaban is increasing. Patients initiated with rivaroxaban or apixaban in general have a higher predicted stroke and bleeding risks compared with warfarin or dabigatran initiators.
Source: Europace - January 29, 2015 Category: Cardiology Authors: Olesen, J. B., Sorensen, R., Hansen, M. L., Lamberts, M., Weeke, P., Mikkelsen, A. P., Kober, L., Gislason, G. H., Torp-Pedersen, C., Fosbol, E. L. Tags: Atrial fibrillation Source Type: research

How are patients with atrial fibrillation approached and informed about their risk profile and available therapies in Europe? Results of the European Heart Rhythm Association Survey
This European Heart Rhythm (EHRA) Scientific Initiatives Committee EP Wire Survey aimed at exploring the common practices in approaching patients with atrial fibrillation (AF) and informing them about their risk profiles and available therapies in Europe. In the majority of 53 responding centres, patients were seen by cardiologists (86.8%) or arrhythmologists (64.2%). First- and follow-up visits most commonly lasted 21–30 and 11–20 min (41.5 and 69.8% of centres, respectively). In most centres (80.2%) stroke and bleeding risk had the highest priority for discussion with AF patients; 50.9% of centres had a struc...
Source: Europace - February 26, 2015 Category: Cardiology Authors: Potpara, T. S., Pison, L., Larsen, T. B., Estner, H., Madrid, A., Blomstrom-Lundqvist, C., Conducted by the Scientific Initiatives Committee, and European Heart Rhythm Association, Conducted by the Scientific Initiatives Committee, and European Heart Rhyt Tags: EP WIRE Source Type: research

Long-term evaluation of dabigatran 150 vs. 110 mg twice a day in patients with non-valvular atrial fibrillation
Conclusion Annualized rates of all outcomes were constant with better efficacy of D150, less major bleeding with D110, and low intracerebral haemorrhage rates for both doses. There were no additional safety concerns. This is the longest continuous randomized experience of a novel anticoagulant.
Source: Europace - June 28, 2016 Category: Cardiology Authors: Ezekowitz, M. D., Eikelboom, J., Oldgren, J., Reilly, P. A., Brueckmann, M., Kent, A. P., Pogue, J., Spahr, J., Clemens, A., Noack, H., Diener, H.-C., Wallentin, L., Yusuf, S., Connolly, S. J. Tags: Atrial fibrillation Source Type: research

Effectiveness and safety of dabigatran versus acenocoumarol in 'real-world patients with atrial fibrillation
Conclusion In ‘real-world’ patients with AF, dabigatran appears to be as effective, but significantly safer than acenocoumarol.
Source: Europace - August 30, 2016 Category: Cardiology Authors: Korenstra, J., Wijtvliet, E. P. J., Veeger, N. J. G. M., Geluk, C. A., Bartels, G. L., Posma, J. L., Piersma-Wichers, M., Van Gelder, I. C., Rienstra, M., Tieleman, R. G. Tags: Atrial fibrillation Source Type: research